Description:The Skid Row Housing Trust (SRHT) in Los Angeles, California has been selected for a SAMHSA Grantee Spotlight for December 2012. SRHT recruits the most vulnerable, chronically homeless individuals who self-identify as having a mental health or substance abuse/dependency disorder and provides them with permanent housing. The Skid Row Housing Trust has developed a unique model that recognizes the multiple pathways an individual experiencing homelessness may follow, and provides assistance as they reenter their communities (HRC).

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Skid Row Housing Trust (SRHT), based in downtown Los Angeles, administers Community Initiative for Integrated Care Services (CIICS), a grantee of SAMHSA’s Cooperative Agreements to Benefit Homeless Individuals (CABHI) program. The agency received the grant in September 2011.

CIICS aims to recruit the most vulnerable, chronically homeless individuals who have identified themselves as having a mental health or substance abuse/dependency disorder. It provides permanent housing within 23 Section 8 subsidized buildings.

Skid Row Housing Trust is a strong believer in the Housing First Model, and ensures that each of the resident’s rights to housing is upheld at all levels of services and management. They believe that housing is a public health issue and that humans have the right not to sleep in the streets, not be exposed to the elements, and to have access to appropriate medical treatment. CIICS, using the Housing First Model, decided to house all program eligible residents as quickly as possible. The staff assists with the transition, and it is not until after a few weeks of case management sessions that participants are encouraged to access all, or any, of the services available to them.

CIICS, together with their partners, determines whether individuals can be fast tracked into housing due to their Vulnerability Index (VI) and their scores on both the Mental Health Screener and the Substance Abuse Screener. Identified individuals who meet the criteria are fast tracked into Section 8 housing through the Hilton Prioritization Program, which enables CIICS to house them within a month, without going through a time-consuming background check from the local Housing Authority.

Once individuals are housed, a simple assessment is conducted according to stipulations from the Government Performance and Results Act (GPRA). Participants then meet with their case manager every week, or as often as possible, to support their transition into permanent housing, address current needs, and support them in the engagement process of accessing mental health and substance abuse/dependency treatment, medical and dental services, and public (legal) counsel for accessing public benefits.

During the first year of the grant, CIICS enrolled 25 participants (the project’s goal is 20 participants every year) who are engaging in the services provided by partner agencies. Individuals who access services are provided with immediate and ongoing weekly support, while those who do not yet want to engage in the available services through CIICS are supported and provided with information that they may need. All providers working with residents have been trained in Motivational Interviewing and undergo monthly supervision from Dr. Liz D'Amico, a nationally recognized researcher with the RAND Corporation. CIICS is expected to enroll all of their second year participants prior to December 2012 in order to ensure that participants have access to the provided services for a longer period of time.

The CIICS staff reflects the population they serve: there are three African Americans, three Latino-Hispanics, and three Caucasians. Program staff undergo intensive training in benefits, quality assurance, continuous quality improvement, and continuous meetings with the program evaluator, Dr. Sarah Hunter, also a staff member at the RAND Corporation. All staff members practice the harm reduction approach, and utilize the transtheoretical model and its stages of change in order to slowly address the issues that clients present. Mindfulness therapy is also practiced, and many skills workshops are provided that aim at assisting clients to achieve a basic level of computer literacy. Clients are also provided training in meditation, art, and vocational education when applicable.

CIICS has developed three strong partnerships for treatment: Los Angeles Christian Health Center, Public Counsel Law Center, and Homeless Health Care Los Angeles. These three agencies, along with Skid Row Housing Trust, are the core program providers. CIICS has worked closely with the CABHI grant steering committee and members of the Consortium. The steering committee has developed a unique model to address the multiple pathways that an individual experiencing homelessness may travel as he or she becomes a thriving member of the community, or society in general. This program has just finished its first year of service, and CIICS is extremely proud of those persons who were chronically homeless with a mental health or substance abuse/dependence disorder who have adapted to permanent housing and are beginning to engage in different programs.

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